Monday Medical: Birth control — other uses

Hormonal birth control isn’t just about preventing pregnancy: it can help treat various health issues.

“These are medicines for women’s health,” said Dr. Mary Bowman, an obstetrician/gynecologist at UCHealth Women’s Care Clinics in Steamboat Springs and Craig. “They can be first-line treatments.”

Below, Bowman outlines conditions how hormonal birth control works and which conditions it can help address.

How hormonal birth control works

Each month, the brain communicates with the ovaries via hormones, telling the ovaries it’s time to ovulate. The ovaries then answer the brain and tell the uterus to prepare for a possible pregnancy. If a pregnancy does not take place, the uterus sheds its lining through menstruation.

But with hormonal birth control, that cycle is interrupted.

In the case of birth control pills, the patch and the ring, versions of estrogen and progesterone trick a woman’s body into thinking she’s pregnant.

“We interrupt the communication between the brain and ovary,” Bowman said. “The brain sees hormones are already in your system, so doesn’t alert the ovaries to do anything.”

Injections and the patch use a version of progestin for a similar effect, while intrauterine devices, or IUDs, use localized hormones to make the uterine lining a hostile environment or create a mucus plug in the cervix to keep sperm from entering.

Acne

Women who struggle with acne and haven’t had success with topical treatments may want to try low-dose birth control pills, which help reduce acne by changing the hormonal balance in the body.

“Since the hormones are systemic, or go through a patient’s whole body, they can sop up extra testosterone, which helps clear up the skin,” Bowman said.

Ovarian pain and cysts

Birth control pills, the patch and ring can also help women who struggle with ovarian cysts and ovarian pain.

“You turn off the brain’s signal to ovulate, so the ovary doesn’t make a follicle, which means it can’t turn into a cyst,” Bowman said.

Painful periods

Cramping takes place when the uterine lining thickens in preparation for a possible pregnancy. By preventing the ovaries from telling the uterus to prepare, the uterus stays quiet and pain is often diminished.

“If you have bad periods — heavy bleeding, cramping, discomfort — any of the hormonal methods are going to help,” Bowman said. “IUDs are my first choice because their effect is isolated to the uterus.”

Cyclic mood changes

The rising and falling hormone levels can wreak havoc on some women’s mood. Low-dose birth control pills may help women dealing with premenstrual dysphoric disorder, which causes severe depression, irritability or anxiety in the days and weeks leading up to menstruation.

“Some people do better if they don’t have hormonal cycles affecting their brains,” Bowman said.

Unpredictable cycles

Some women have conditions that prevent regular ovulation, which can put them at risk for some health issues. These women may consider low-dose birth control pills, the patch, ring or an IUD, all of which suppress the ovaries and lessen problems associated with ovarian dysfunction.

Reduced cancer risk

“Studies show women who have used low-dose birth control pills for at least five years at some point in life have a decreased risk of ovarian cancer,” Bowman said. “And for women who are at risk for uterine cancer for a variety of reasons, birth control pills and IUDs may decrease that risk.”

Pre-menopausal use of low-dose birth control pills is not associated with increased breast cancer risk.

Don’t hesitate to reach out to your health care provider with any questions and concerns.

“Please don’t be worried about talking to your doctor about things that might be bothersome,” Bowman said. “We’re used to hearing a lot of questions, and we might have something that can help — and that might be easier than you think.”